Surgery to treat urinary incontinence in women, by means of the vesical suspension technique is carried out in the following manner:
Preparation: shaving, disinfecting the skin and vaginal mucous membrane.
Position: gynecologic.
Incision: transversal, suprapubic some 4 cms. long, covering all the subcutaneous cellular tissue coming close to the anterior aponeurosis of the anterior straight abdominal muscles.
Technique: Insertion by means of cystoscopic control of the two leading needles following a paraurethral path, adapted to the concavity of the posterior surface of the pubis, from the aponeurosis of the straight muscles up to the anterior surface of the vagina, where they are externalized with a separation of some 2 cm.
Transversal dissection of the vaginal mucous membrane between the two outlet points of the leading needles for the purpose of preparing a submucous tunnel.
Threading the corresponding needles of both ends of synthetic or silk thread suture to which a silicone tube about 4 cm. long will have been previously inserted for the purpose of cushioning the urethra.
Exteriorization of both ends of the suture above the aponeurosis of the straight muscles, by means of pulling on the leading needles.
Suture with loose stitches the vaginal incision.
Pulling and knotting the synthetic or silk thread suture.
Under cystoscopic control the suitable closing of the vesical neck and recovery of the posterior urethrovesical angle will be checked.
Suture of the subcutaneous plane with loose stitches. Intradermal suture skin, with loose silk stitches.
Permanent vesical catheter.